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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

Nhs students and lack of consent.

809 replies

MarbleQueen · 21/01/2022 21:26

I’m wondering if something has changed within the Nhs. At one time you were asked if you minded having a student being present.In my area they are present at every appointment without any discussion and I’m getting fed up with it.

In the last two years these things have happened.

A student midwife was brought into my room and participated in my delivery without any discussion. She was instructed to break my waters and deliver my baby without any discussion with myself. The midwife focused on talking her through things instead of supporting me. I was alone because of covid restrictions. I later discovered it was the first baby she delivered. I felt like a piece of meat.

I went for a smear and when I walked in the room there was a nurse and 3 very young women present. When I asked who they were I was told they were trainee health care assistants. I objected and the nurse insinuated I was being a bit silly and shy. I left that appointment without it being done.

I had a dentist appointment for my first ever dental treatment. I told them I was nervous. Again when I went in, I was told, not asked that the 2 people present were dental students and would only be observing. The dentist focused on explaining things to them and actually allowed one to place the filling. I didn’t agree to this.

I went to a gp apointment for something intimate to find a man around 18 years old sat in the room. Again I had to ask who he was and was told he was a student. I had to ask for him to leave and it was really uncomfortable.

I had an apointment to have a very unpleasant procedure. There was the usual student perched in the corner without any discussion. Again I had to ask who they were and was told, not asked, that they would be observing. The doctor focused on explaining things to them and when the procedure was finished I actually realised 3 more students had been brought in to watch without me noticing.

I have previously had a type of abdominal cancer. I have checks with scans and have seen the same consultant for years. On my last visit there was the usual student perched in the corner without any discussion. On this occasion, and this occasion only, the surgeon suggested doing a VE. I asked him what information he was hoping to get from this considering he had a recent MRI scan in front of him and he simply dropped it. I strongly suspect this was going to be for the students benefit because it certainly wasn’t going to benefit me.

Each of these places have standard notices in their waiting rooms informing you that a student might be present but this is not consent. I think this is now something you have to actively opt out of instead of opting in.

Has anyone else noticed this happening? I worry about what these students are learning about consent in these circumstances.

OP posts:

OnceuponaRainbow18 · 22/01/2022 17:41

After 26 incredibly painful hours being in labour I was asked if a student midwife could check
To see how man cm dilated I was- I said no way and was made to feel a bit mean!

I was asked if a student GP could watch my sons 10 week review- I said sure

Other than that I’m not sure I’ve had any more

HonestwithHope1 · 22/01/2022 17:40

@justlyra.

Ta. Not shifting responsibility at all but agree to disagree

Informed consent is essential. Hope we can all agree on that one

JustLyra · 22/01/2022 17:39

you literally argued with me that a phone call to a patient wouldn't take that long. .....

Which is not remotely the same as someone demanding something…

Original poster

MarbleQueen · 22/01/2022 17:39

MarbleQueen oh give over. We discussed this. You said how in the example of student sitting in room, when arguing with me re in consent, that you should have been told via phone call pre apppointment. Then argued with me how long phone calls take

Nope. Didn’t happen. Perhaps you’ve got me mixed up with someone else.

I’m not keen on being accused of tantrumming or being emotional because I don’t want 3;teenage students watch me having a smear test. I’m not the only poster concerned about your lack of understanding about consent.

OP posts:

JustLyra · 22/01/2022 17:38

[quote HonestwithHope1]@JustLyra

Then you ring up before if it's that awful to say the word 'no' at a standard apppointment or you get an advocate/family member ect.

Simple.

Multiple people have also pointed out that it takes less than a minute to say yes or no, no excuses needed- and realistically the majority of people will happily answer the question honestly.

I don't believe OP fully. I believe there's elements of the truth and clear emotional hurt here. But no. I also don't agree with op demanding health professionals call her before appointment

I've had one experience in 28 years of life as a disabled person requiring numerous treatment, and I consented but didn't have full informed consent (see post) and never ever witnessed or done it myself re lack of informed consent. So yeah. multiple disregards in the space of a short time, for informed consent is strange.[/quote]
The point you are missing though is that the most vulnerable are the people that are most likely to feel unable to say no in a room full of students already sat in place.

The onus on getting clear, informed consent is not on patients. It’s on medical professionals. Shifting the responsibility is not acceptable and shouldn’t happen.

You’ve had one yet many others on the thread have had more than one. Your experience is not universal.

HonestwithHope1 · 22/01/2022 17:37

NoRaceInThisHorse

Why do i have to keep repeating myself are you going to reply to anything I've said in a discussion?

not true at all.
Also, presumably this issue is around pre + currently covid so.... Again. As said before, advocate/carer/family/friend ....
again. The majority of people, when asked on the day, 'this is X student, can they sit in/observe/treat' are happy to, on the day - in front of the student, answer yes or no.

If you aren't part of that majority then it's your responsibility to arrange to speak to staff before appointment or getting someone else to ring.

@MarbleQueen hun you literally argued with me that a phone call to a patient wouldn't take that long. .....

greenmarlin · 22/01/2022 17:32

Has it occurred to you that when people have a bad experience with a student they are far more likely to decline students in the future? Who does this benefit exactly?

That's exactly what happened to me. Students trooped in for my forceps delivery without my consent. I still don't know how many there were or if they were male or female because I was barely awake, but it was horrific. I felt like I was giving birth in a train station.

For my second birth in a different hospital I wrote on my patient notes "Due to my first birth I do not permit any medical students to observe, and in particular I do not consent for them arriving for the actual birth."

It was respected, thankfully, and I felt much better about that birth on the whole.

Thecurtainsofdestiny · 22/01/2022 17:31

This is absolutely not ok. Consent should be asked for, every time.

I've always been asked if it's ok for a student to be present and never felt pressure to say yes. That's how it should be, in my opinion.

Original poster

MarbleQueen · 22/01/2022 17:30

don't believe OP fully. I believe there's elements of the truth and clear emotional hurt here. But no. I also don't agree with op demanding health professionals call her before appointment

I don’t give a shit what you believe. Plenty of medical people have confirmed that students are not asking for consent like they used to and plenty of people have had similar experiences.

At no point have I demanded I get a call so pack that in.

OP posts:

NoRaceInThisHorse · 22/01/2022 17:29

HonestwithHope1
1- Family members have not been allowed to accompany people for at around 2 years now, although of course you know that.
2- Multiple people have explained why it may be traumatic or difficult to say no, especially if it's worded like "oh this is James, he is a medical student and will be doing your procedure today. Is that OK?"- you'd have to be a fairly confident person to say "actually no, it's not OK"

HonestwithHope1 · 22/01/2022 17:29

JustLyra

Why? The post is an excellent discussion that's clearly needed

@MarbleQueen oh give over. We discussed this. You said how in the example of student sitting in room, when arguing with me re in consent, that you should have been told via phone call pre apppointment. Then argued with me how long phone calls take

I'm sorry you are emotional but having a different opinion is not gaslighting you. I don't entirely believe every experience is as accurate as detailed. Your posts and replies are very pedantic.

And i know entirely about informed consent, as patient, carer and professional.so don't worry :)

HonestwithHope1 · 22/01/2022 17:25

@JustLyra

Then you ring up before if it's that awful to say the word 'no' at a standard apppointment or you get an advocate/family member ect.

Simple.

Multiple people have also pointed out that it takes less than a minute to say yes or no, no excuses needed- and realistically the majority of people will happily answer the question honestly.

I don't believe OP fully. I believe there's elements of the truth and clear emotional hurt here. But no. I also don't agree with op demanding health professionals call her before appointment

Original poster

MarbleQueen · 22/01/2022 17:23

Do one Honestwithhope with your gaslighting bullshit. I never said anything about demanding a phone call.Your lack of regard for consent is clear for all to see.

It seems you’re the one having a tantrum at patients daring to say no.

OP posts:

JustLyra · 22/01/2022 17:17

@HonestwithHope1 Multiple people on the thread have expressed that the student already being there makes it difficult to say no.

Consent gained in that situation is not genuine consent.

If you don't believe the OP then report them, instead of having stroppy fits at people who disagree with you.

Just because you are ok with pressured consent doesn't mean everyone is. and just because you haven't experience multiple shitty experiences with this issue doesn't mean no-one else has.

HacerSonarSusPasos · 22/01/2022 17:16

@powershowerforanhour

Does this happen to men? Like, would a man be led into the room for prostate exam to find a gaggle of students waiting for him to drop his trousers and have the doc in charge say, oh you don't mind if this lot have a go as well do you?

Obviously not. Their dignities must be protected at all costs.

Original poster

MarbleQueen · 22/01/2022 17:16

Why would you object? Surely they will go through everything in more detail to show the students and you might even learn a thing or two! How else are we going to have doctors and nurses and HCAs in the future?!?!

Ffs what don’t you get?
Yes they do sometimes go through everything in more detail. A previous poster described how she had an intimate procedure unnecessarily done SIX TIMES for the benefit of students.

This obviously hasn’t ever happened to you and I don’t think you’d be happy if it did.

OP posts:

HonestwithHope1 · 22/01/2022 17:13

Warmduscher

HOW DARE YOU.

I've clearly fucking explained that my mum has an SMI and you dare say that. Seriously?????

The reality is. If you are that traumatised you can't speak on the day to refuse or give consent for a student. Then you ring up before stating i need only X person at appointment or you take an advocate or get an advocate to ring up on your behalf. I speak to every new service on my mums behalf before appointments and no doubt always will. I know the importance of informed consent.

My issue with OP is threefold

the tantrumming about the student daring to be in the room as the patient enters and how she claimed that wouldn't be consent despite clearly being asked by the health professional

The demand of a special phone call to them before their appointment (lol really they themselves can't have someone ring on their behalf or picking up phone themselves)

And her frankly, many unbelievable encounters with lack of informed consent (see my previous posts detailing why i think this is)

OP is factually wrong re consent + student initially in the room making it a lack of consent regardless. You are offensive.

powershowerforanhour · 22/01/2022 17:00

CorneliusBeefington · 22/01/2022 16:46

@HopelessBlue192

Religious beliefs, PTSD, history of abuse, anxiety, being scared, being confused, feeling out of control in an already uncomfortable situation, past medical trauma, health anxiety, ASD, being overwhelmed, being overstimulated, not wanting to have to share a difficult medical history in front of more people that necessary.

There's loads of reasons why someone would say no.

Just because you would say yes doesn't mean everyone else would.

susannag1978 · 22/01/2022 16:44

I had counselling (via a charity not NHS) over a very sensitive matter and was asked if I would mind if a student sat in the corner of the room to learn from the experience as it was what helped train new counsellors. I was really shocked and said no. I'm so glad they asked me, I wouldn't have had the confidence if they have sprung it upon me and I think the counselling would have been less beneficial.

JustLyra · 22/01/2022 16:41

@HopelessBlue192

Consent is important.

Can you really not think of any occasion where people might not be comfortable having multiple people in the room? For example my first smear after I was raped was an awful, awful experience because it was the first time anyone saw me exposed. You can’t see why I’d prefer that to just be one nurse?

Or that when someone has difficult questions to ask or nervousness they might not want to have the entire thing, their history explained to students rather than just quietly getting things done?

There are enough people who are ok with students that a small number of people not being comfortable with it isn’t a problem.

And a lack of consent is a huge issue with medical things, especially with women, and should always be highlighted

HacerSonarSusPasos · 22/01/2022 16:40

@HopelessBlue192

You mean why would a woman object to having half a dozen young male strangers ogle her private parts and/or awkwardly stare while she undergoes an intimate/scary/painful procedure?

Are you seriously asking this?

LadyLolaRuben · 22/01/2022 16:40

NHS consent advisor here. You can and are well within your rights to only have the clinical person treating you present. Ive refused when distressed or have been feeling anxious. They know its nothing personal. Patients often decline.

HopelessBlue192 · 22/01/2022 16:35

IrritableOwlSyndrome · 22/01/2022 16:30

@draramallama

Posters advocating for a healthcare system that disregards patient consent are advocating for abuse.

I have to wonder why anybody would argue such an abhorrent position.

Probably the type of Tory voter who hates the poor and disabled.

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